Fri Apr 15 2022

62 articles - From Saturday Apr 09 2022 to Friday Apr 15 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…


Meta-analysis

meta-analyses and systematic reviews

Ann Intern Med

Sodium-Glucose Cotransporter-2 Inhibitors in Patients With Heart Failure : A Systematic Review and Meta-analysis.

Among people with heart failure, SGLT2 inhibitors reduce hospitalizations for heart failure regardless of the presence of diabetes; absolute benefits are most pronounced in first-year treatment and vary with prognostic factors. Clinicians should note the increased risk for genital infection in patients receiving SGLT2 inhibitors. Primary funding source 1.3.5 Project for Disciplines of Excellence, West China Hospital of Sichuan University. (PROSPERO CRD42021255544).

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Lancet

Blood pressure meta-analysis highlights an implementation gap - Authors' reply.

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Blood pressure meta-analysis highlights an implementation gap.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Ann Intern Med

How Would You Treat This Patient With Acute and Chronic Pain From Sickle Cell Disease? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

Several of the recommendations are conditional and leave specific decisions to the treating physician. These include conditional recommendations about the use of ketamine for acute pain and the initiation and discontinuation of long-term opioid therapy for chronic pain. Here, 2 hematologists discuss these guidelines and make contrasting recommendations for the management of acute and chronic pain for a patient with sickle cell disease.

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Lancet

Abiraterone plus prednisone added to androgen deprivation therapy and docetaxel in de novo metastatic castration-sensitive prostate cancer (PEACE-1): a multicentre, open-label, randomised, phase 3 study with a 2×2 factorial design.

Interpretation Combining androgen deprivation therapy, docetaxel, and abiraterone in de novo metastatic castration-sensitive prostate cancer improved overall survival and radiographic progression-free survival with a modest increase in toxicity, mostly hypertension. This triplet therapy could become a standard of care for these patients. Funding Janssen-Cilag, Ipsen, Sanofi, and the French Government.

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Aggressive intraoperative warming versus routine thermal management during non-cardiac surgery (PROTECT): a multicentre, parallel group, superiority trial.

Keeping core temperature at least 35·5°C in surgical patients appears sufficient. Funding 3M and the Health and Medical Research Fund, Food and Health Bureau, Hong Kong. Translation For the Chinese translation of the abstract see Supplementary Materials section.

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Estimating global, regional, and national daily and cumulative infections with SARS-CoV-2 through Nov 14, 2021: a statistical analysis.

This information might also be useful for targeted transmission-prevention interventions, including vaccine prioritisation. Our statistical approach to estimating SARS-CoV-2 infection allows estimates to be updated and disseminated rapidly on the basis of newly available data, which has and will be crucially important for timely COVID-19 research, science, and policy responses. Funding Bill & Melinda Gates Foundation, J Stanton, T Gillespie, and J and E Nordstrom.

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Health system performance in Iran: a systematic analysis for the Global Burden of Disease Study 2019.

Although the Iranian health-care system has been successful to some extent in controlling mortality, it has overlooked the burden of morbidity and need for rehabilitation. We did not capture alleviation of the burden of diseases in Iran following the 2004 and 2014 health sector reforms; however, the sanctions were associated with deaths of Iranians caused by NCDs. Funding Bill & Melinda Gates Foundation.

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Long-term efficacy and safety of renal denervation in the presence of antihypertensive drugs (SPYRAL HTN-ON MED): a randomised, sham-controlled trial.

Interpretation Radiofrequency renal denervation compared with sham control produced a clinically meaningful and lasting blood pressure reduction up to 36 months of follow-up, independent of concomitant antihypertensive medications and without major safety events. Renal denervation could provide an adjunctive treatment modality in the management of patients with hypertension. Funding Medtronic.

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Symptom prevalence, duration, and risk of hospital admission in individuals infected with SARS-CoV-2 during periods of omicron and delta variant dominance: a prospective observational study from the ZOE COVID Study.

Interpretation The prevalence of symptoms that characterise an omicron infection differs from those of the delta SARS-CoV-2 variant, apparently with less involvement of the lower respiratory tract and reduced probability of hospital admission. Our data indicate a shorter period of illness and potentially of infectiousness which should impact work-health policies and public health advice. Funding Wellcome Trust, ZOE, National Institute for Health Research, Chronic Disease Research Foundation, National Institutes of Health, and Medical Research Council.

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N Engl J Med

Fourth Dose of BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting.

A fourth dose of the BNT162b2 vaccine was effective in reducing the short-term risk of Covid-19-related outcomes among persons who had received a third dose at least 4 months earlier. (Funded by the Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute.).

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Mitapivat versus Placebo for Pyruvate Kinase Deficiency.

In patients with pyruvate kinase deficiency, mitapivat significantly increased the hemoglobin level, decreased hemolysis, and improved patient-reported outcomes. No new safety signals were identified in the patients who received mitapivat. (Funded by Agios Pharmaceuticals; ACTIVATE ClinicalTrials.gov number, NCT03548220.).

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Neoadjuvant Nivolumab plus Chemotherapy in Resectable Lung Cancer.

In patients with resectable NSCLC, neoadjuvant nivolumab plus chemotherapy resulted in significantly longer event-free survival and a higher percentage of patients with a pathological complete response than chemotherapy alone. The addition of nivolumab to neoadjuvant chemotherapy did not increase the incidence of adverse events or impede the feasibility of surgery. (Funded by Bristol Myers Squibb; CheckMate 816 ClinicalTrials.gov number, NCT02998528.).

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Nonoperative or Surgical Treatment of Acute Achilles' Tendon Rupture.

In patients with Achilles' tendon rupture, surgery (open repair or minimally invasive surgery) was not associated with better outcomes than nonoperative treatment at 12 months. (Funded by the South-Eastern Norway Regional Health Authority and Akershus University Hospital; ClinicalTrials.gov number, NCT01785264.).

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Rilzabrutinib, an Oral BTK Inhibitor, in Immune Thrombocytopenia.

Rilzabrutinib was active and associated with only low-level toxic effects at al dose levels. The dose of 400 mg twice daily was identified as the dose for further testing. Overall, rilzabrutinib showed a rapid and durable clinical activity that improved with length of treatment. (Funded by Sanofi; ClinicalTrials.gov number, NCT03395210; EudraCT number, 2017-004012-19.).

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Ann Intern Med

Belt and Suspenders: Vaccines and Tixagevimab/Cilgavimab for Prevention of COVID-19 in Immunocompromised Patients.

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Community-Acquired Pneumonia.

Diagnosis requires suggestive history and physical findings in conjunction with radiographic evidence of infiltrates. Laboratory testing can help guide therapy. Important issues in treatment include choosing the proper venue, timely initiation of the appropriate antibiotic or antiviral, appropriate respiratory support, deescalation after negative culture results, switching to oral therapy, and short treatment duration.

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Now Is the Time to Make Screening for Lung Cancer Reportable.

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Lancet

Endometrial cancer.

Minimally invasive surgical staging and sentinel-lymph-node biopsy provides a low morbidity alternative to historical surgical management without compromising oncological outcomes. Adjuvant radiotherapy reduces loco-regional recurrence in intermediate-risk and high-risk cases. Advances in our understanding of the molecular biology of endometrial cancer have paved the way for targeted chemotherapeutic strategies, and clinical trials will establish their benefit in adjuvant, advanced, and recurrent disease settings in the coming years.

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The Ockenden review and women's health in the UK.

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N Engl J Med

Acute Achilles' Tendon Rupture - Surgery or No Surgery.

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Audio Interview: Do the Tobacco Wars Offer Any Lessons for the Vaccine Wars?

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Cancer-Associated Hypercalcemia.

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Covid-19 Boosters - Where from Here?

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Expanding Horizons for Treatment of Early-Stage Lung Cancer.

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Letters&Replies

Letters to the editors and authors’ replies

Lancet

Caring for Ukrainian refugee children with acute and chronic diseases.

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Children growing up in conflict zones in Ukraine and beyond need urgent mental health support.

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COVID-19 vaccination and HIV-1 acquisition - Authors' reply.

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COVID-19 vaccination and HIV-1 acquisition.

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SARS-CoV-2 nucleic acid testing is China's key pillar of COVID-19 containment.

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What comes next in the COVID-19 pandemic?

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N Engl J Med

A Microbiota-Directed Food Intervention for Undernourished Children.

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A Microbiota-Directed Food Intervention for Undernourished Children. Reply.

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Closed-Loop Control in Very Young Children with Type 1 Diabetes.

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Closed-Loop Control in Very Young Children with Type 1 Diabetes.

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Closed-Loop Control in Very Young Children with Type 1 Diabetes. Reply.

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Rapid Diagnostic Testing for SARS-CoV-2.

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Rapid Diagnostic Testing for SARS-CoV-2. Reply.

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Others

all remaining publications eg case reports, images of the month, etc…

Ann Intern Med

Web Exclusive. Annals Graphic Medicine - The Things We Share.

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Lancet

Atypical arrhythmogenic presentation of giant cell myocarditis diagnosed after heart transplant.

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Can renal denervation replace medications for patients with hypertension?

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Challenging dogma about perioperative warming during non-cardiac surgery.

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David Tennent Baird.

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How to interpret the total number of SARS-CoV-2 infections.

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Ockenden report a "watershed moment".

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Offline: Ukraine-difficult lessons for global health.

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Smart apps for self-reporting clinical information.

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The Canada Gairdner Awards 2022.

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The roots of social medicine: a story of relationships.

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Triplet therapy for prostate cancer.

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Understanding the changing health of the Iranian people.

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WHO sexual abuse allegations: 6 months on.

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N Engl J Med

Case 11-2022: An 80-Year-Old Woman with Pancytopenia.

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Continuation of Bisphosphonate Therapy for Osteoporosis beyond 5 Years.

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From Resentment to Reconnection - Reflections on Caring for the Unvaccinated.

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Governance of Emerging Technologies in Health and Medicine - Creating a New Framework.

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How Can We Fully Realize SNAP's Health Benefits?

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Knife-Cut Ulcers in Crohn's Disease.

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Radiographic Evolution of Presumed Septic Pulmonary Emboli.

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Reassessing Quality Assessment - The Flawed System for Fixing a Flawed System.

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The 2022 Child Nutrition Reauthorization - An Opportunity to Advance Children's Health.

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The Tobacco Wars' Lessons for the Vaccination Wars.

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